ARCHWAY ORAL SURGERY AND DENTAL IMPLANTS (NPI# 1184130528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184130528 |
| Entity Type | Organization |
| Organization Name | ARCHWAY ORAL SURGERY AND DENTAL IMPLANTS |
| Practice Address |
16 Hampton Village Plz Ste 200 Saint Louis MO 63109-2128 |
| Practice Telephone | 3143285995 |
| Practice Fax Number | 3143285996 |
| Mailing Telephone | 3143285995 |
| Mailing Fax Number | 3143285996 |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2017-12-21 |
| Authorized Official Name | TYMAN LOVELESS (OWNER / SURGEON) |
| Authorized Official Telephone | 3143285995 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
16 HAMPTON VILLAGE PLZ STE 200 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63109-2128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
| 1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
| 1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
| 1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
| 1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
| 1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
| 1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
| 1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
| 1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
| 1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
| Find all providers in zip 63109 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346382678 | Ramani Gowducheruvu | Dentist | 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 | 2007-02-13 |
| 1528503026 | Stewart E Moreland, Dmd, LLC | Dentist | 2821 N Ballas Rd, Suite 225, Saint Louis, MO 63131-2321 | 2016-12-20 |
| 1891107132 | Creve Coeur Oral Surgery | Dentist | 605 Old Ballas Rd, Suite 130, Saint Louis, MO 63141-7000 | 2014-05-21 |
| 1396180436 | Dustin R Altmann | Dentist | 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 | 2013-05-02 |
| 1164866125 | Gregory Stephen Tentindo | Dentist | 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 | 2013-04-22 |
| 1073800520 | Dominic Morel-maynard | Dentist | 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 | 2011-07-06 |
| 1568788925 | Collin Miles Stutz | Dentist | 605 Old Ballas Rd, Saint Louis, MO 63141-7000 | 2010-04-10 |
| 1821228628 | Robert Alexander Peter Reti | Dentist | 10000 Watson Rd, A, Saint Louis, MO 63126-1841 | 2009-07-15 |
| 1982870663 | Marc Gayed | Dentist | 4121 Elm Park Dr, Saint Louis, MO 63128 | 2008-05-02 |
| 1114190220 | Allen Sclaroff Dds Inc | Dentist | 1 Barnes Jewish Hospital Plz, Suite 16432, Saint Louis, MO 63110-1003 | 2008-04-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63109 |
Please comment or provide details below to improve the information on ARCHWAY ORAL SURGERY AND DENTAL IMPLANTS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.